First Edition: April 25, 2013

Today's headlines include health policy headlines from Capitol Hill and from the insurance markeplace. 

Kaiser Health News: Maryland Offers Glimpse At Obamacare Insurance Math
Kaiser Health News staff writer Jay Hancock reports: "In the latest preview of prices for health coverage under the Affordable Care Act, Maryland's dominant insurer says proposed premiums for new policies for individuals will rise by 25 percent on average next year. That's lower than what some had predicted. Just three weeks ago, the insurer, CareFirst BlueCross BlueShield, had been looking at a proposed 50 percent increase. But the company revised that initial estimate, citing worries about affordability for consumers" (Hancock, 4/24). Read the story.

Kaiser Health News: Capsules: States Spend $28M, Then Leave Exchanges To The Feds
Now on Kaiser Health News' blog, Phil Galewitz writes: "Late last year, Arizona Gov. Jan Brewer announced that her state would not build its own online insurance marketplace, a pillar of the Affordable Care Act, because there were too many unknowns. What Brewer didn't say was that her state had spent $9 million in federal money to reach that conclusion. Arizona was one of 10 states that received federal grants over the past two years to help establish a state exchange only to decide later to let the federal government handle it" (Galewitz, 4/24). Check out what else is on the blog.

The New York Times: House Majority Leader's Quest To Soften G.O.P.'s Image Hits A Wall Within
On Wednesday, Republican leaders abruptly shelved one of the centerpieces of Mr. Cantor's "Making Life Work" agenda -; a bill to extend insurance coverage to people with pre-existing medical conditions -; in the face of a conservative revolt. Last month, legislation to streamline worker retraining programs barely squeaked through. … So it has gone. Items that Mr. Cantor had hoped would change the Republican Party's look, if not its priorities, have been ignored, have been greeted with yawns or have only worsened Republican divisions (Weisman, 4/24).

Los Angeles Times: Republican Effort To Rebrand The Party Takes A Hit
Cantor's approach echoed the "compassionate conservatism" of an earlier Republican era. … That ambitious goal ran smack into political reality Wednesday as conservative lawmakers rejected a Republican bill to help Americans with preexisting health conditions gain access to insurance coverage. Republican leaders had to abruptly yank the bill from consideration because they did not have enough votes from their rank and file to pass it. The episode was another example of the difficulty the Republican Party faces in corralling its unruly majority and finding a common message to attract voters (Mascaro, 4/24).

The Washington Post: House GOP Leadership Falls On Health Vote
House Republican leaders suffered a humiliating legislative setback Wednesday when a large faction of GOP lawmakers rebelled against a leadership proposal that had drawn the opposition of powerful outside activists. The mutiny forced House Majority Leader Eric Cantor (Va.) to abruptly pull from the floor legislation to shore up a program that allows people with preexisting health conditions to buy into an insurance pool for high-risk patients before they are able to transition to coverage under President Obama's health-care law. … The Club for Growth led a contingent of right-leaning groups that urged Republican lawmakers to oppose the bill, casting it as a costly boondoggle that would do nothing to dismantle the health-care law (Kane, 4/24).

The Associated Press/Washington Post: GOP Postpones Vote To Use Disease-Prevention Money To Extend Coverage For High-Risk Patients
GOP leaders postponed a scheduled vote after the measure met strong opposition from two directions: from conservative groups resistant to any federal role in health care and from Democrats who objected that the Republicans planned to pay for the high-risk patient program by raiding a disease prevention provision the administration says is essential to the overhaul (4/24).

The Wall Street Journal's Washington Wire: GOP Shelves Legislation Attacking Obama Health Law
Their bill had been scheduled for a House vote but was abruptly pulled from the calendar in the face of conservative and Democratic opposition. The measure would abolish a $2 billion fund to pay for public health initiatives and channel the money instead to a program to help provide insurance for people with pre-existing conditions (Hook, 4/24).

Politico: GOP Pulls Contentious Obamacare Bill
It's a blow to the Virginia Republican, who touted the "Helping Sick Americans Now Act" and visited the Republican Study Committee meeting Wednesday to try to move votes (Sherman, 4/24).

The Associated Press/Washington Post: For GOP And Democrats, Deficit Reduction Is More Talk Than Action As Neither Side Compromises
For years, House Republicans have adamantly refused to raise income taxes, even though U.S. taxes are historically low, and the Bush-era tax cuts were a major cause of the current deficit. And now, top Democrats are staunchly opposing changes to Medicare and Social Security benefits, despite studies showing the programs' financial paths are unsustainable. Unless something gives, it's hard to see what will produce the significant compromises needed to tame the federal debt, which is nearing $17 trillion (4/25).

Politico: Tom Harkin Makes Hurdle For Obama's CMS Chief
Harkin told POLITICO he'd hold up the confirmation "until we get some things worked out." He said he's meeting with the administration about the prevention money and has some ideas about other ways to get the funds. Congress has not granted HHS the money it has requested to get the health insurance exchanges up and running (Cunningham and Haberkorn, 4/24).

The Washington Post's Wonk Blog: Sen. Harkin Has A Hold On Obama's Medicare Pick. What Gives?
The Senate Finance Committee unanimously supported her nomination. She has the support of multiple former Medicare heads; one compared her to Mother Teresa. Even House Majority Leader Eric Cantor (R-Va.), who does not like Obamacare one bit, really likes Marilyn Tavenner. Enter, Sen. Tom Harkin, the Iowa Democrat who has put a hold on Tavenner's nomination. Harkin is demanding, according to spokeswoman Katie Cyrul Frischmann, "An ongoing conversation about the future of the prevention fund" (Kliff, 4/24).

Politico: Lawmakers, Aides May Get Obamacare Exemption
Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama's health care overhaul, sources in both parties said (Bresnahan and Sherman, 4/24).

Politico: WH Taps CAP's McGuinness For Obamacare Push
Tara McGuinness, a well-regarded strategic communications expert currently serving as a senior vice-president at the Center for American Progress and executive director of the think-tank's advocacy arm, and will be reunited with former CAP-er Jen Palmieri as a senior White House communications advisor. She'll be focusing on communications and outreach around Affordable Care Act implementation. The move signals a new focus in the White House communications operation on the ACA, an administration official tells POLITICO (Thrush, 4/24).

Politico: CO-OP 'Movement' Offers An Insurance Alternative
The public option is dead. Long live CO-OPs! That's the chant from mostly grass-roots health reformers in 24 states, backed by billions of dollars in government loans, who are gearing up to offer alternatives to commercial insurance plans on the exchanges next fall (Norman, 4/25).

The Washington Post's Wonk Blog: With Health Law Looming, One Large Insurer Wants A 25 Percent Premium Hike
Maryland's biggest health insurer proposed raising premiums for individual policies by an average of 25 percent next year, saying that President Obama's health law would require it to accept even the sickest applicants, driving up costs. The CareFirst BlueCross BlueShield plan must be approved by the state, and officials immediately indicated that there would be close scrutiny of the double-digit boost (Kliff and Somashekhar, 4/24).

Los Angeles Times: WellPoint Posts 3% Profit Gain And Raises Full-Year Outlook
Insurance giant WellPoint Inc. reported a 3% increase in first-quarter profit and raised its full-year outlook as the company prepares for major changes under the federal healthcare overhaul. WellPoint, which runs Anthem Blue Cross in California and health plans in 13 other states, said its results were lifted by a recent acquisition that helped boost enrollment of the nation's second-largest health insurer to nearly 36 million people (Terhune, 4/25).

The Associated Press/Washington Post: WellPoint's 1st Quarter Profit Rises 3 Percent, Health Insurer Raises 2013 Forecast
WellPoint shares hit their highest level since the summer of 2011 on Wednesday after the nation's second largest health insurer trumped first-quarter earnings expectations, raised its 2013 forecast and said it could profit immediately from a key health care overhaul coverage expansion next year (4/24).

NPR: Family Doctors Consider Dropping Birth Control Training Rule
One of the more popular provisions of the federal health law requires that women be given much freer access to prescription methods of birth control. That includes not only the pill, but implants and IUDs as well. But what happens if there are not enough doctors to prescribe those contraceptives? That's exactly what worries some reproductive health advocates, as efforts are underway to rewrite rules governing the training of the nation's family doctors (Rovner, 4/25).

The New York Times: New Medical Exam Policy For Sexual Assault Cases
Techniques for collecting and analyzing evidence in rape cases have evolved over the last decade, as has the understanding of the psychological effects of sexual assault. But how health practitioners, law enforcement officers, prosecutors and others respond after a rape still varies widely across the country (Goode, 4/24).

Los Angeles Times: Employer Health Premiums Rose 170% In California In Last Decade
Premiums for employer health insurance in California jumped 170% over the last decade, more than five times the 32% increase in the state's inflation rate. That escalation in premiums has taken a toll on employers' willingness to offer health benefits, according to an annual survey by the California HealthCare Foundation (Terhune, 4/24).

Los Angeles Times: Federal Judge Renews Order For California Prison Mental Health Plan
Even as California makes preparations to appeal federal court rulings on the quality of care and crowding of conditions in state prisons, new orders are in the making. U.S. District Judge Lawrence Karlton on Tuesday dusted off a pending August 2012 order for the state to produce a plan to improve the quality of inmate mental health care, and gave it a new July 1 deadline. The judge's order notes that compliance was interrupted by the state's bid in January to end court oversight of prison mental health care (St. John, 4/24).